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Overview
The New York Times1 and the Registered Dental Hygienist 2 have reported new evidence supporting the effectiveness of fluoride varnish in preventing early childhood caries, based on the findings of a study published in the Journal of Dental Research.3
The two-year study from the University of California-San Francisco (UCSF) was a randomized controlled trial that evaluated caries incidence in 376 caries-free children from low-income, primarily Hispanic or Chinese families in the San Francisco area. The children ranged in age from 6 months to 3½ years, and all were required to have at least four erupted maxillary incisors. Each child participating in the study received oral health counseling from their parents or caregivers, and 202 children remained in the study for the duration. The study found that children receiving no fluoride varnish were more than twice as likely to have dental caries as those who had annual varnish treatments, and nearly four times as likely to have cavities than children who received fluoride varnish at six-month intervals.
Fluoride varnish is a topical agent containing a high concentration of fluoride (5 percent sodium fluoride (NaF) or 22,600 ppm of fluoride) in a resin or synthetic base. Professionally applied fluoride varnishes were first developed in the 1960s, and have been in use for over 30 years.
Fluoride varnishes are painted directly onto teeth and are intended to remain in close contact with enamel for several hours. Fluoride varnish sets on contact with intraoral moisture, so thorough drying prior to application is not required. Application time runs from one to four minutes, depending on the number of teeth within the oral cavity. In a typical varnish application, 0.3 to 0.5 milliliters (mL) of varnish are painted directly onto the teeth (0.1 mL of varnish was applied per arch in the UCSF study). Varnish may be applied with any convenient applicator (e.g., a disposable brush or cotton-tipped applicator, or the syringe-type applicator included with the product). After application, the fluoride varnish remains on the tooth surfaces for several hours, which facilitates maximal fluoride uptake. Fluoride varnish also minimizes the risk of inadvertent fluoride consumption and is easy to use on very young children.
The ADA considers fluoride varnish to be safe and efficacious as part of a caries prevention program that includes caries diagnosis, risk assessment, and regular dental care. The U.S. Food and Drug Administration has cleared these products as medical devices to be used as cavity liners and for the treatment of hypersensitive teeth. These products have not yet been cleared for marketing in the United States as caries-preventive agents; and, therefore, fluoride varnish application for caries prevention is an off-label use. However, the results of this recent study add to an increasing body of evidence supporting the effectiveness of fluoride varnish in caries prevention.
Finally, this study lends support to the recommendation that children have their first dental visit within six months of eruption of the first tooth and no later than 12 months of age.
Footnotes
1 Bakalar N. Dental health: Fluoride varnish found to cut cavities in children. The New York Times, Science Times, Feb 7, 2006. Available at:
http://select.nytimes.com/gst/abstract.html?
res=FB0D15FB3C5A0C748CDDAB0894DE404482 
2 Fluoride varnish helps prevent tooth decay. Registered Dental Hygienist (online article). Available at: “ http://rdh.pennnet.com/Articles/Article_Display.cfm?ARTICLE_ID=246799&
p=56&cat=OnFea ”. Accessed Feb. 10, 2006.
3 Weintraub JA, Ramos-Gomez F, Jue B, Shain S, Hoover CI, Featherstone JD, Gansky SA.. Fluoride varnish efficacy in preventing early childhood caries. J Dent Res 2006 Feb;85(2):172-176.
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A–Z Topic: Fluoride and Fluoridation
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Science in the News is a service by the American Dental Association (ADA) to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.
Document Posted February 2006
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